Sepsis
Sepsis is a life-threatening condition caused by the immune response of an organism to severe infection. Sepsis is characterized by overwhelming systemic (i.e. not localised) inflammation. It is often associated with coagulation disorders and dysfunction of the circulatory system. Even under optimal treatment, dysfunction of many organ systems may progress to multiple organ failure and eventually death.
Sepsis is particulary common and dangerous in elderly, immunocompromised, and critically ill patients, where it is a major cause of death in intensive care units worldwide. In the United States, sepsis is the leading cause of death in non-coronary ICU patients, while recent 1998 data from the Centers for Disease Control show that it is the 11th leading cause of death overall. Mortality rates ranging from 28 to 50% have been reported for sepsis.
The therapy of sepsis rests on antibiotic (and in some cases, surgical) treatment of the causating infection, fluid replacement, adequate nutrition (including parenteral nutrition), and appropriate support for organ dysfunction. This may include hemodialysis in renal failure, mechanical ventilation in pulmonary dysfunction, transfusion of blood plasma, platelets and coagulation factors to stabilize blood coagulation, and drug and fluid therapy for circulatory failure. Therapeutic strategies aimed at the inflammation process itself have largely failed to improve outcome. However, the infusion of activated Protein C, a coagulation factor, has recently been shown to improve survival in sepsis. Low dose cortisol also seems to be beneficial.
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